Nocardia abscessus – Unusual Source of Nasal Inflammation

Authors: J. Krtičková 1;  L. Ryšková 2;  P. Králíčková 5;  J. Scharfen jr. 2,3;  J. Dědková 4;  P. Vítková 2,3
Authors‘ workplace: Klinika otorinolaryngologie a chirurgie hlavy a krku LF UK a FN Hradec Králové 1;  Ústav klinické mikrobiologie LF UK a FN Hradec Králové 2;  Oddělení mikrobiologie, Národní referenční laboratoř pro patogenní aktinomycety, Nemocnice Trutnov 3;  Radiologická klinika LF UK a FN Hradec Králové 4;  Ústav klinické imunologie a alergologie FN Hradec Králové 5
Published in: Otorinolaryng. a Foniat. /Prague/, 62, 2013, No. 3, pp. 126-131.
Category: Case History


We report a case of unusual microbiological findings. Injury of the nose in the garden was followed by inflammation of the soft tissues. Gram smear showed bacteria of Nocardia sp., subsequent phenotype and genotype analyses identified Nocardia abscessus. CT examination did not reveal any damage to the hard tissues. The patient was treated with combination of antibiotics and surgical debridement. The authors point out the necessity of microbiological phenotypic and genotypic identification of Nocardia species for the purpose of targeted therapy.

Nocardia abscessus, cutaneous nocardiosis, phenotypic method, genotypic method


1. Baroni, M. R., Noroña, M., Ronchi, S., Mayoral, C.: Necrotizing lymphadenitis caused by Nocardia asteroides in a healthy girl. Rev. Argent. Microbiol., 36, 2004. s.75-77.

2. Boiron, P., Provost, F., Chevrier, G., Dupont, B.: Review of nocardial infections in France 1987 to 1990. Eur J. Clin. Microbiol. Infect Dis., 11, 1992, s. 709-714.

3. Burton, D. M., Burgess, L. P.: Nocardiosis of the upper aerodigestive tract. Ear Nose Throat J., 69, 1990, s. 350-353.

4. Daeschlein, G., Fetouh Yassin, A. A., Franke, A., Kramer, A., Schaal, K. P.: Unusual infections: Femoral abscess due to Nocardia abscessus in a patient suffering from metastatic peripheral bronchial carcinoma and hygienic consequences. GMS Krankenhhyg Interdiszip., 6, 2011, Doc03. doi: 10.3205/dgkh000160. Epub 2011 Dec 15.

5. Diego, C., Ambrosioni, J. C., Abel, G., Fernando, B., Tomás, O., Ricardo, N., Jörge, B.: Disseminated nocardiosis caused by Nocardia abscessus in an HIV-infected patient: First reported case., AIDS, 19, 2005, s. 1330-1331.

6. Dodiuk-Gad, R., Cohen, E., Ziv, M., Goldstein, L. H., Chazan, B., Shafer, J., Sprecher, H., Elias, M., Keness, Y., Rozenman, D.: Cutaneous nocardiosis: report of two cases and review of the literature. Intm. J. Dermatol., 49, 2010, s.1380-1385.

7. Gyotoku, T., Kayashima, K., Nishimoto, K., Ono, T.: Cutaneous nocardiosis developing around gravel inserted during a traffic injury. J. Dermatol., 29, 2002, s. 803-809.

8. Horré, R., Schumacher, G., Marklein, G., Stratmann, H., Wardelmann, E., Gilges, S., De Hoog, G. S., Schaal, K. P.: Mycetoma due to Pseudallescheria boydii and co-isolation of Nocardia abscessus in a patient injured in road accident. Med. Mycol., 40, 2002, s. 525-527.

9. Kageyama, A., Yazawa, K., Ishikawa, J., Hotta, K., Nishimura, K., Mikami, Y.: Nocardial infections in Japan from 1992 to 2001, including the first report of infection by Nocardia transvalensis. Eur J. Epidemiol., 1 9, 2004, s. 383-389.

10. Katz, P., Fauci, A. S.: Nocardia asteroides sinusitis. Presentation as a trimethoprim-sulfamethoxazole responsive fever of unknown origin. JAMA., 28, 1977, s. 2397-2398.

11. Maraki, S., Scoulica, E., Nioti, E., Tselentis, Y.: Nocardial infection in Crete, Greece: Review of fifteen cases from 2003 to 2007., Scandinavian Journal of Infectious Diseases, 41, 2000, s. 122-127.

12. Marchandin, H., Eden, A., Jean-Pierre, H., Reynes, J., Jumas-Bilak, E., Boiron, P., Laurent, F.: Molecular diagnosis of culture-negative cerebral nocardiosis due to Nocardia abscessus. Diagn. Microbiol. Infect Dis., 55, 2006, s. 237-240.

13. Mereghetti, L., van der Mee-Marquet, N., Dubost, A.F., Boiron, P.: Nocardia otitidiscaviarum infection of a traumatic skin wound. Eur J. Clin. Microbiol. Infect Dis., 16, 1997, s. 383-384.

14. McNeil, M. M., Brown, J.: The medically important aerobic actinomycetes: epidemiology and microbiology. Clin. Microbiol. Rev., 7, 1994, s. 357–417.

15. Muñoz, J., Mirelis, B., Aragón, L. M., Gutiérrez, N., Sánchez, F., Español, M., Esparcia, O., Gurguí, M., Domingo, P., Coll, P.: Clinical and microbiological features of nocardiosis 1997-2003. J. Med. Microbiol., 56, 2007, s. 545-550.

16. Poonwan, N., Mekha, N., Yazawa, K., Thunyaharn, S., Yamanaka, A., Mikami, Y.: Characterization of clinical isolates of pathogenic Nocardia strains and realted actionomyces in Thailand from 1996 to 2003. Mycopathologia., 159, 2005, s. 361-368.

17. Reddy, A. K., Garg, P., Kaur, I.: Spectrum and clinicomicrobiological profile of Nocardia keratitis caused by rare species of Nocardia identified by 16S rRNA gene sequencing. Eye (Lond), 24, 2010, s. 1259-1262.

18. Roberts, S. A., Bartley, J., Braatvedt, G., Ellis-Pegler, R.B.: Nocardia asteroides as a c.ause of sphenoidal sinusitid. Clin. Infect Dis., 21, 1995, s. 1041-1042.

19. Saoji, V.A., Saoji, S. V., Gadegone, R. W., Menghani, P. R.: Primary cutaneous nocardiosis. Indian J. Dermatol., 57, 2012, s. 404-406.

20. Scharfen J. jr.: Nokardióza: doporučená metoda mikrobiologické diagnostiky s přehledem léčby nokardiózy a návrhem standardního operačního postupu. NUCLEUS, Hradec Králové, 2008, ISBN 978-80-87009-43-7.

21. Scharfen, J. jr., Morávková, M., Buncek, M., Hobza, V., Plísek, S., Urbásková, P., Sedlácek, I., Zemlicková, H., Stárková, H., Paterová, P.: Nocardia farcinica as the causative agent of a brain abscess in a patient with interstitial lung disease. Epidemiol. Mikrobiol. Imunol., 59, 2010, s. 13-20

22. Sherber, N. S., Olivere, J. W., Martins, C. R.: An 80-year-old man with a nonhealing glabellar lesion. Arch. Pathol. Lab. Med., 130, 2006, s.100-101.

23. Unzaga, M. J., Crovetto, M. A., Santamaría, J. M., Rojo, P., Llanos, A., Ezpeleta, C., Cisterna, R.: Maxillary sinusitis caused by Nocardia nova. Clin. Infect Dis., 23, 1996, s. 184-185.

24. Wauters, G., Avesani, V., Charlier, J., Janssens, M., Vaneechoutte, M., Delmée, M.: Distribution of nocardia species in clinical samples and their routine rapid identification in the laboratory. J. Clin. Microbiol., 43, 2005, s. 2624-2628.

25. Yassin, A. F., Rainey, F. A., Mendrock, U., Brzezinka, H., Schaal, K.P.: Nocardia abscessus sp. nov.. Int. J. Syst. Evol. Microbiol., 50, 2000, s. 1487-1493.

Audiology Paediatric ENT ENT (Otorhinolaryngology)
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